Vitamin D assays and the definition of hypovitaminosis D: results from the First International Conference on Controversies in Vitamin D

Christopher T. Sempos, Annemieke C. Heijboer, Daniel D. Bikle, Jens Bollerslev, Roger Bouillon, Patsy M. Brannon, Hector F. DeLuca, Glenville Jones, Craig F. Munns, John P. Bilezikian, Andrea Giustina, Neil Binkley

Research output: Contribution to journalReview articleAcademicpeer-review

Abstract

The First International Conference on Controversies in Vitamin D was held in Pisa, Italy, 14–16 June 2017. The meeting's purpose was to address controversies in vitamin D research, review the data available, to help resolve them, and suggest a research agenda to clarify areas of uncertainty. The serum 25-hydroxyvitamin D [25(OH)D] concentration [i.e. the sum of 25(OH)D3 and 25(OH)D2] remains the critical measurement for defining vitamin D status. Assay variation for 25(OH)D has contributed to the current chaos surrounding efforts to define hypovitaminosis D. An essential requirement to develop a consensus on vitamin D status is that measurement of 25(OH)D and, in the future, other potential vitamin D biomarkers [e.g. 1α,25(OH)2D3, 3-epi-25(OH)D, 24,25(OH)2D3, vitamin D-binding protein, free/bioavailable 25(OH)D and parathyroid hormone] be standardized/harmonized, to allow pooling of research data. Vitamin D Standardization Program tools are described and recommended for standardizing 25(OH)D measurement in research. In the future, similar methodology, based on National Institute for Standards and Technology standard reference materials, must be developed for other candidate markers of vitamin D status. Failure to standardize/harmonize vitamin D metabolite measurements is destined to promulgate continued chaos. At this time, 25(OH)D values below 12 ng ml–1 (30 nmol l–1) should be considered to be associated with an increased risk of rickets/osteomalacia, whereas 25(OH)D concentrations between 20 ng ml–1 and 50 ng ml–1 (50–125 nmol l–1) appear to be safe and sufficient in the general population for skeletal health. In an effort to bridge knowledge gaps in defining hypovitaminosis D, an international study on rickets as a multifactorial disease is proposed.
Original languageEnglish
Pages (from-to)2194-2207
JournalBritish Journal of Clinical Pharmacology
Volume84
Issue number10
DOIs
Publication statusPublished - 2018

Cite this

Sempos, Christopher T. ; Heijboer, Annemieke C. ; Bikle, Daniel D. ; Bollerslev, Jens ; Bouillon, Roger ; Brannon, Patsy M. ; DeLuca, Hector F. ; Jones, Glenville ; Munns, Craig F. ; Bilezikian, John P. ; Giustina, Andrea ; Binkley, Neil. / Vitamin D assays and the definition of hypovitaminosis D: results from the First International Conference on Controversies in Vitamin D. In: British Journal of Clinical Pharmacology. 2018 ; Vol. 84, No. 10. pp. 2194-2207.
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title = "Vitamin D assays and the definition of hypovitaminosis D: results from the First International Conference on Controversies in Vitamin D",
abstract = "The First International Conference on Controversies in Vitamin D was held in Pisa, Italy, 14–16 June 2017. The meeting's purpose was to address controversies in vitamin D research, review the data available, to help resolve them, and suggest a research agenda to clarify areas of uncertainty. The serum 25-hydroxyvitamin D [25(OH)D] concentration [i.e. the sum of 25(OH)D3 and 25(OH)D2] remains the critical measurement for defining vitamin D status. Assay variation for 25(OH)D has contributed to the current chaos surrounding efforts to define hypovitaminosis D. An essential requirement to develop a consensus on vitamin D status is that measurement of 25(OH)D and, in the future, other potential vitamin D biomarkers [e.g. 1α,25(OH)2D3, 3-epi-25(OH)D, 24,25(OH)2D3, vitamin D-binding protein, free/bioavailable 25(OH)D and parathyroid hormone] be standardized/harmonized, to allow pooling of research data. Vitamin D Standardization Program tools are described and recommended for standardizing 25(OH)D measurement in research. In the future, similar methodology, based on National Institute for Standards and Technology standard reference materials, must be developed for other candidate markers of vitamin D status. Failure to standardize/harmonize vitamin D metabolite measurements is destined to promulgate continued chaos. At this time, 25(OH)D values below 12 ng ml–1 (30 nmol l–1) should be considered to be associated with an increased risk of rickets/osteomalacia, whereas 25(OH)D concentrations between 20 ng ml–1 and 50 ng ml–1 (50–125 nmol l–1) appear to be safe and sufficient in the general population for skeletal health. In an effort to bridge knowledge gaps in defining hypovitaminosis D, an international study on rickets as a multifactorial disease is proposed.",
author = "Sempos, {Christopher T.} and Heijboer, {Annemieke C.} and Bikle, {Daniel D.} and Jens Bollerslev and Roger Bouillon and Brannon, {Patsy M.} and DeLuca, {Hector F.} and Glenville Jones and Munns, {Craig F.} and Bilezikian, {John P.} and Andrea Giustina and Neil Binkley",
year = "2018",
doi = "10.1111/bcp.13652",
language = "English",
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pages = "2194--2207",
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Sempos, CT, Heijboer, AC, Bikle, DD, Bollerslev, J, Bouillon, R, Brannon, PM, DeLuca, HF, Jones, G, Munns, CF, Bilezikian, JP, Giustina, A & Binkley, N 2018, 'Vitamin D assays and the definition of hypovitaminosis D: results from the First International Conference on Controversies in Vitamin D' British Journal of Clinical Pharmacology, vol. 84, no. 10, pp. 2194-2207. https://doi.org/10.1111/bcp.13652

Vitamin D assays and the definition of hypovitaminosis D: results from the First International Conference on Controversies in Vitamin D. / Sempos, Christopher T.; Heijboer, Annemieke C.; Bikle, Daniel D.; Bollerslev, Jens; Bouillon, Roger; Brannon, Patsy M.; DeLuca, Hector F.; Jones, Glenville; Munns, Craig F.; Bilezikian, John P.; Giustina, Andrea; Binkley, Neil.

In: British Journal of Clinical Pharmacology, Vol. 84, No. 10, 2018, p. 2194-2207.

Research output: Contribution to journalReview articleAcademicpeer-review

TY - JOUR

T1 - Vitamin D assays and the definition of hypovitaminosis D: results from the First International Conference on Controversies in Vitamin D

AU - Sempos, Christopher T.

AU - Heijboer, Annemieke C.

AU - Bikle, Daniel D.

AU - Bollerslev, Jens

AU - Bouillon, Roger

AU - Brannon, Patsy M.

AU - DeLuca, Hector F.

AU - Jones, Glenville

AU - Munns, Craig F.

AU - Bilezikian, John P.

AU - Giustina, Andrea

AU - Binkley, Neil

PY - 2018

Y1 - 2018

N2 - The First International Conference on Controversies in Vitamin D was held in Pisa, Italy, 14–16 June 2017. The meeting's purpose was to address controversies in vitamin D research, review the data available, to help resolve them, and suggest a research agenda to clarify areas of uncertainty. The serum 25-hydroxyvitamin D [25(OH)D] concentration [i.e. the sum of 25(OH)D3 and 25(OH)D2] remains the critical measurement for defining vitamin D status. Assay variation for 25(OH)D has contributed to the current chaos surrounding efforts to define hypovitaminosis D. An essential requirement to develop a consensus on vitamin D status is that measurement of 25(OH)D and, in the future, other potential vitamin D biomarkers [e.g. 1α,25(OH)2D3, 3-epi-25(OH)D, 24,25(OH)2D3, vitamin D-binding protein, free/bioavailable 25(OH)D and parathyroid hormone] be standardized/harmonized, to allow pooling of research data. Vitamin D Standardization Program tools are described and recommended for standardizing 25(OH)D measurement in research. In the future, similar methodology, based on National Institute for Standards and Technology standard reference materials, must be developed for other candidate markers of vitamin D status. Failure to standardize/harmonize vitamin D metabolite measurements is destined to promulgate continued chaos. At this time, 25(OH)D values below 12 ng ml–1 (30 nmol l–1) should be considered to be associated with an increased risk of rickets/osteomalacia, whereas 25(OH)D concentrations between 20 ng ml–1 and 50 ng ml–1 (50–125 nmol l–1) appear to be safe and sufficient in the general population for skeletal health. In an effort to bridge knowledge gaps in defining hypovitaminosis D, an international study on rickets as a multifactorial disease is proposed.

AB - The First International Conference on Controversies in Vitamin D was held in Pisa, Italy, 14–16 June 2017. The meeting's purpose was to address controversies in vitamin D research, review the data available, to help resolve them, and suggest a research agenda to clarify areas of uncertainty. The serum 25-hydroxyvitamin D [25(OH)D] concentration [i.e. the sum of 25(OH)D3 and 25(OH)D2] remains the critical measurement for defining vitamin D status. Assay variation for 25(OH)D has contributed to the current chaos surrounding efforts to define hypovitaminosis D. An essential requirement to develop a consensus on vitamin D status is that measurement of 25(OH)D and, in the future, other potential vitamin D biomarkers [e.g. 1α,25(OH)2D3, 3-epi-25(OH)D, 24,25(OH)2D3, vitamin D-binding protein, free/bioavailable 25(OH)D and parathyroid hormone] be standardized/harmonized, to allow pooling of research data. Vitamin D Standardization Program tools are described and recommended for standardizing 25(OH)D measurement in research. In the future, similar methodology, based on National Institute for Standards and Technology standard reference materials, must be developed for other candidate markers of vitamin D status. Failure to standardize/harmonize vitamin D metabolite measurements is destined to promulgate continued chaos. At this time, 25(OH)D values below 12 ng ml–1 (30 nmol l–1) should be considered to be associated with an increased risk of rickets/osteomalacia, whereas 25(OH)D concentrations between 20 ng ml–1 and 50 ng ml–1 (50–125 nmol l–1) appear to be safe and sufficient in the general population for skeletal health. In an effort to bridge knowledge gaps in defining hypovitaminosis D, an international study on rickets as a multifactorial disease is proposed.

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UR - https://www.ncbi.nlm.nih.gov/pubmed/29851137

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DO - 10.1111/bcp.13652

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SN - 0306-5251

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